Acute pancreatitis complicated with choledochal duct rupture

Abstract

Recurrent acute pancreatitis is a rare clinical entity in childhood with unknown incidence (Rosendahl et al., 2007) and often occurring in a familial context. Genetic factors such as PRSS1 mutations (cationic trypsinogen gene) can be found in some patients. However, many remain idiopathic. The natural history remains poorly documented and the most frequent complications reported are pain, exocrine pancreatic insufficiency, diabetes mellitus, and pancreatic adenocarcinoma after long-standing hereditary pancreatitis. We describe a patient with hereditary pancreatitis in whom a mild pancreatitis episode was complicated by a perforation of the ductus choledochus.

Figure 1

A: MRCP images demonstrating the subcapsular effusion, dilatated choledochus, and the choledochus rupture. B: ERCP images from leaking choledochus and stent placement.

Figure 2

A: MRCP images demonstrating normalisation of the biliary tree after removal of the stent. B: ERCP image from choledochus after stent removal.